Three years ago, a project
was initiated to link the local area networks (LANs) of
institutions in the northern part of New York state. The
network would provide the local communities in the
Adirondack Mountains region with continuing medical
education, distance learning, videoconferencing,
telemedicine, and remote legal advice.

Having grown up
in the area, David Bonner, currently the director of
technology initiatives at The Sage Colleges and president
and CEO of the Adirondack Area Network (AANet), knew that
the telecom infrastructure there was poor at best.

David
Bonner, current director of technology
initiatives at The Sages Colleges and
president/CEO of the AANet, spearheaded the
regional videoconferencing and distance-learning
solution. He also became the first patient at the
Albany Medical Center whose minimal invasive
surgery was broadcast over that network.
Bonner(left) and Ken Sperl, vice president of
networking services, in the OR, with Jackie Ford
(via video), director of academic technologies
from AMC's ATM network.

"I did some legwork ahead of time and found that
the people wanted something done," he says. A
requirement was that the solution be inexpensive, yet
provide all the traditional line services and
videoconferencing capabilities.

Today, AANet serves more than 150 institutions,
including colleges, school districts, healthcare centers,
legal organizations, hospitals, and the St. Regis Mohawk
Tribe. In addition to connections within New York state,
institutions from the neighboring states and the Canadian
province of Quebec want to join the network. In fact,
AANet is confident that it will have 150 more members on
line by the year 2000.

Network Technology

Originally funded by the New York State Advanced
Telecommunications project (a Bell Atlantic grant), the
AANet is a state-of-the-art subscription-based
full-service network. Its implementation in early 1997,
spearheaded by Bonner, began through the combined efforts
of information technology experts in the Albany area. The
collaboration included: The Sage Colleges; Albany Medical
Center; Franklin-Essex-Hamilton BOCES (Board of
Cooperative Educational Services) in Malone; Champlain
Valley Educational Services in Plattsburgh; Bell
Atlantic; RADVision, Inc.; Tandberg; Cisco; VTEL; the New
York State Education and Research Network (NYSERNet); and
New York state. With its fast growth rate, it quickly
became an independent Section 501(c)(3) not-for-profit
organization.

Since ATM was difficult to obtain and Frame Relay
available, the team developed the initial services to be
IP over Frame Relay in the wide area. In order to make
the best use of high-quality H.320-compliant systems
installed in various member facilities, they deployed
RADVision's OnLAN videoconferencing gateways and video
interface units (VIUs) to make the H.320 systems work
over the IP networks. "We have found this to be a
very cost-effective way to convert legacy H.320 systems
for use on this network. In addition, the H.323 boxes
provide a routable protocol. In this fashion, we are able
to accommodate video calls from any source and line
media," Bonner says.

The combination of gateways and VIU terminal adapters
for group video systems permits AANet users to
communicate between campus local area networks and the
Internet via Frame Relay. Other industry-leading
companies supplying expertise and technology for this
innovative videoconferencing network include Bell
Atlantic, Cisco Systems, RealTech, and Compression Labs,
Inc.

AANet played an essential
role in disaster-recovery efforts after the
record-breaking ice storms, snow, and intense cold that
devastated this remote region in January 1998. Since then
the AANet has expanded. There are more than 70 group
videoconferencing end points on the network and 40
additional IP-videoconferencing desktop systems. These
systems come from many manufacturers, such as Tandberg,
VCON, VTEL, Intel, and PictureTel.

"We show users
the different options they have and let them choose what
they prefer," says Bonner. "We are familiar
with all the products and know that, for most
applications, they interoperate smoothly over our
network. We also offer H.323 training to our member
organizations. This is primarily for those local area
network managers who want to know a little more about
their options and how to set up and manage their zones.
Their local seats have access to our infrastructure,
including H.323 MCUs (multipoint conferencing units) and
video network gateways."

Currently, for bridging, AANet has four RADVision MCUs
(with nine ports each) and a H.320 VideoServer MCU (12
v.35 ports, 12 BRI ports, and 1 PRI port), and it plans
to add to this capacity. Using gateways for front-ending
the Videoserver MCU, and the MCUs as multipliers on these
ports, the AANet presently supports a port density of 50
(8x4 + 11 + 4 + 3). Plans are to continue the MCUs
multiplying effect to obtain a port density of 402
(8x4x12 + 11 + 4 + 3). Bonner says, "It is
interesting to note that this port density even supports
continuous presence, speed matching, and mixing of H.320,
H.232e, and H.323 in a given bridged conference
call."

Distance-Learning Program

The Albany Medical Center (AMC) conducted a
groundbreaking distance program when the hospitals
connected to the AANet participated in a live
videoconference of a minimally invasive surgery
procedure. To make this procedure visible to all call
participants, the operation was broadcast to two rooms
within AMC consisting of the operating room (OR) itself
and a large conference room on campus. Joining in the
conference via Frame Relay were five other sites in New
York (AO Fox Hospital in Oneonta; Adirondack Medical
Center, Saranac; Champlain Valley Physicians Hospital in
Plattsburgh; Mary McClellan Hospital, Cambridge; and The
Sage Colleges, Troy).

This new surgical technique allows the surgeon to
perform the operation from outside the patient's body
with the aid of scopes and porthole tools. The scopes,
lasers, and other surgical devices are placed through
portholes within the patient's body. The patient's
surgery and the instruments are visible in a split
screen, while the surgeon is viewed in the other portion
of the screen. During the surgery the surgeon's scopes
and workspace video are encoded and digitally mixed in
real time. The multipoint distance-learning call is
completely interactive, so that the surgeon can be seen
and heard by participants who may ask questions in real
time while viewing the operation. In this case, the
patient was Dr. Bonner himself, who had a bilateral
hernia repair under general anesthesia. Only three hours
later, Bonner participated in the opening of the medical
center's MIS training unit.

According to Dr. Paul Singh, the Albany Medical Center
plans to do several on-line surgeries every month. There
may be larger, university-based long-distance learning
projects in existence, but none can be characterized by
the kind of unique technical solution as that developed
by this wide variety of companies, organizations, and
institutions. By all accounts, this high-quality,
reliable, easy, flexible, and inexpensive
videoconferencing application is well ahead of its time.

Dr. Blank is vice president of global marketing
for RADVision, Inc., Mahwah, N.J.